Celiac Disease: Gluten Free Diet (cont.)

Betty Kovacs, MS, RD

Betty is a Registered Dietitian who earned her B.S. degree in Food and Nutrition from Marymount College of Fordham University and her M.S. degree in Clinical Nutrition from New York University. She is the Co-Director and Director of nutrition for the New York Obesity Research Center Weight Loss Program.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are the difficulties with following a gluten-free diet?

Following a gluten-free diet is not as simple as purchasing gluten-free
foods. To start with, not every food has a gluten free option and not everyone
has access to stores that sell the products that are gluten free. Many of these
foods can be costly and that presents another barrier to compliance with this.
The labeling laws can also make compliance difficult when they allow incomplete
description of food components.

Even with the best intentions you can end up consuming gluten without know
it. Gluten can be found in unexpected sources such as in pharmaceuticals (acts
as a binder), meat products (acts as extender), or in confectionery, desserts,
flavorings and sauces. Cross contamination poses the greatest obstacle when
foods are not prepared at home or in a carefully controlled environment.
Travelling, eating out, parties, and other social events fall under this
category.

Dietary deficiencies are a higher risk for people with celiac disease than
for others who follow a gluten-free diet. Anyone who is eliminating food groups
should be aware of the nutrients that they may be missing. The deficiencies to
be aware of are iron, calcium, vitamin B12, folate, phosphorus, and the fat
soluble vitamins A, D, E, and K. Protein-calorie malnutrition is another
possible risk that can be avoided with an adequate intake of high protein foods.

What foods do you avoid on a gluten-free diet?

When you begin to make this adjustment to your diet it can feel overwhelming.
Start by getting used to the things that you want to avoid. The purpose of
eliminating gluten is to improve your health, so remind yourself that you are
cutting these out to feel better, not to deprive yourself of anything.

Gluten is the protein found in the grains wheat, rye, barley, and triticale
(a hybrid of wheat and rye). Read the labels on foods, health and beauty aids,
and medications carefully and don't assume that the ingredients stay the same.
Something that did not contain gluten could contain it the next time you
purchase it. Keep this list with you: